CN104546104A - 一种胫骨远端内侧钩钢板 - Google Patents

一种胫骨远端内侧钩钢板 Download PDF

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CN104546104A
CN104546104A CN201510034132.0A CN201510034132A CN104546104A CN 104546104 A CN104546104 A CN 104546104A CN 201510034132 A CN201510034132 A CN 201510034132A CN 104546104 A CN104546104 A CN 104546104A
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张晖
李亚星
屠重棋
宋跃明
黄富国
刘凯
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West China Hospital of Sichuan University
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment

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Abstract

一种胫骨远端内侧钩钢板，包括板体和钩体，所述板体包括近端部和远端部，所述远端部的宽度大于近端部的宽度，板体上沿轴线方向均匀地开有可调螺钉孔，钩体连接在板体远端部，钩体上有两个锋利的尖钩，板体的内侧面内凹，板体远端部向外弯曲，钩体向内弯曲，板体的内侧面及钩体内表面与胫骨远端内侧骨外形相适配。钩体的两个锋利尖钩经空心螺钉加压后可使之进入内踝尖骨质，在骨折远端形成三角形多平面立体固定，加强了抗扭转能力，可防止骨折远的内踝前后移位，降低二次复位丢失危险。板体近端部经螺钉固定，能作为防滑钢板有效阻止远端骨块移位，对于有内踝上角关节软骨下方骨质压缩者，钩钢板固定还可起到支撑钢板作用，防止关节面再次塌陷。

Description

一种胫骨远端内侧钩钢板
技术领域
本发明涉及一种医疗装置，特别是治疗内踝处骨折的装置。
背景技术
踝关节骨折是下肢常见骨折，按目前常用的Lauge-Hansen分型可以在诊断踝关节骨折类型的同时了解踝关节损伤程度，为复位内固定提供指导作用。其中旋后-内收型踝关节损伤的受伤机制是当足处于旋后位时遭受内收应力，外踝受到牵拉，首先发生低位横形或短斜形骨折，少数伴有外侧副韧带撕裂(Ⅰ度损伤)；随后足内收时，距骨在踝穴内受到强力内收外力作用，以类似圆锥体运动轨迹在踝穴内滚动，进而内踝受到挤压，在内侧韧带张力下发生垂直方向骨折(Ⅱ度损伤)。Ⅱ度损伤时由于处于旋后位的足遭受内收应力，距骨与内踝关节接触撞击，往往导致关节软骨面损伤，甚至塌陷；而且极少数严重的旋后-内收型踝关节损伤可能会累及三角韧带深层，进一步造成小的撕脱骨折。
踝关节所承载的主要应力为负重、扭转，为满足踝关节的早期功能锻炼，需对内、外踝骨折提供良好的支撑及抗扭转能力，这就要求对远端骨折块行多钉固定，以提供有效把持性能，获得良好的抗压能力；同时需提供多平面立体固定，从而获得良好的抗扭转能力。
现行的踝关节骨折复位后常规采用克氏针张力带钢丝、2枚空心加压螺钉或可吸收螺钉固定，也有研究采用双皮质全螺纹螺钉固定。此类患者内踝的垂直向骨折线在踝关节活动时会产生高剪切应力，应用上述传统方式固定后，因内固定未垂直于骨折线会造成固定强度降低，对踝关节早期功能锻炼产生一定影响，易导致内固定失效或骨折端移位。
发明内容
本发明旨在提供一种胫骨远端内侧钩钢板，对骨折的胫骨远端进行立体固定，增加抗扭能力，可防止内踝前后移位，降低二次复位丢失危险。
一种胫骨远端内侧钩钢板，包括板体和钩体，所述板体包括近端部和远端部，所述远端部的宽度大于近端部的宽度，板体上沿轴线方向均匀地开有可调螺钉孔，所述钩体连接在板体远端部，钩体上有两个锋利的尖钩，钩体上设有固定螺钉孔，所述板体的内侧面内凹，所述板体远端部向外弯曲，所述钩体向内弯曲，所述板体的内侧面及钩体内表面与胫骨远端内侧骨外形相适配。
进一步的，所述板体远端部设有3—6个螺钉孔。
优选的，所述板体远端部的螺钉孔为6个。
进一步的，所述板体远端部设有三个克氏固定孔。
进一步的，所述钩体的宽度与板体近端部的宽度一致。
进一步的，所述板体和钩体为钛合金制备。
本发明钢板钩体的两个锋利尖钩经空心螺钉加压后可使之进入内踝尖骨质，不仅起到加压作用，还在骨折远端形成三角形多平面立体固定，加强了抗扭转能力；而且两个尖钩钩入骨质，可防止一旦骨折远端螺钉松动而导致的内踝前后移位，降低二次复位丢失危险。板体近端部上的多个螺孔，可通过侧方多螺钉固定，不仅能作为防滑钢板有效阻止远端骨块移位，而且对于有内踝上角关节软骨下方骨质压缩者，行关节面下植骨后，钩钢板固定还可起到支撑钢板作用，防止关节面再次塌陷。
附图说明
图1为本发明结构示意图。
图2为图1所示结构的俯视图。
图3为图1所示结构的左视图。
图4为本发明结构的立体示意图。
图中：1-近端部，2-可调螺钉孔，3-远端部，4-尖钩，5-内侧面，6-螺钉孔，7-克氏固定孔，8-钩体，9-固定螺钉孔，10-板体。
具体实施方式
下面结合附图对本发明作进一步详细说明。
如图1-4所示，本发明一种胫骨远端内侧钩钢板，包括板体10和钩体8，所述板体10包括近端部1和远端部3，所述远端部3的宽度大于近端部1的宽度，板体10上沿轴线方向均匀地开有可调螺钉孔2，所述钩体8连接在板体10远端部3，钩体8上有两个锋利的尖钩4，钩体8上设有固定螺钉孔9，所述板体10的内侧面5内凹，所述板体10远端部3向外弯曲，所述钩体8向内弯曲，所述板体10的内侧面5及钩体8内表面与胫骨远端内侧骨外形相适配。
进一步的，所述板体10远端部3设有3—6个螺钉孔6，可进行更好地固定定位。
优选的，所述板体10远端部3的螺钉孔6为6个。
进一步的，所述板体10远端部3设有三个克氏固定孔7，克氏固定孔7在螺钉孔6的外侧。
进一步的，所述钩体8的宽度与板体10近端部1的宽度一致。
进一步的，所述板体10和钩体8为钛合金制备，组织相容性好，板体可以制备得更薄，无需进行骨膜剥离，有效保护骨折端的血液运动；其材料及形态特点使之具有弹性固定的性能，允许骨折端间的微动，使骨折产生应力剌激从而有利于骨愈合，达到生物学固定的目的。。
本发明适用于内踝处骨折，特别是Ⅱ度旋后-内收型内踝骨折。钩体的两个锋钊尖钩，经空心螺钉加压后可使之进入内踝尖骨质，不仅起到了加压作用，还在骨折远端形成三角形多平面立体固定，加强了抗扭能力；而且远端的2个尖钩钩入骨质，可防止一旦骨折远端螺钉松动而导致的内踝前后移位，降低二次复位危险。板体近端部上的多个螺孔，可通过侧方多螺钉固定，不仅能作为防滑钢板有效阻止远端骨块移位，而且对于有内踝上角关节软骨下方骨质压缩者，行关节面下植骨后，钩钢板固定还可起到支撑钢板作用，防止关节面再次塌陷。
显然，以上实施方式仅仅是对本发明所作的举例，而并非对本发明实施方式的限定。对于所属领域的技术人员来说，在上述说明的基础上还可以做出其它不同形式的变化或变动。这里无需也无法对所有的实施方式予以穷举。而这些属于本发明的精神所引申出的显而易见的变化或变动仍处于本发明的保护范围之中。

Claims (6)

1.一种胫骨远端内侧钩钢板，其特征在于：包括板体(10)和钩体(8)，所述板体(10)包括近端部(1)和远端部(3)，所述远端部(3)的宽度大于近端部(1)的宽度，板体(10)上沿轴线方向均匀地开有可调螺钉孔(2)，所述钩体(8)连接在板体(10)远端部(3)，钩体(8)上有两个锋利的尖钩(4)，钩体(8)上设有固定螺钉孔(9)，所述板体(10)的内侧面(5)内凹，所述板体(10)远端部(3)向外弯曲，所述钩体(8)向内弯曲，所述板体(10)的内侧面(5)及钩体(8)内表面与胫骨远端内侧骨外形相适配。
2.根据权利要求1所述的胫骨远端内侧钩钢板，其特征在于：所述板体(10)远端部(3)设有3—6个螺钉孔(6)。
3.根据权利要求1所述的胫骨远端内侧钩钢板，其特征在于：所述板体(10)远端部(3)的螺钉孔(6)为6个。
4.根据权利要求1所述的胫骨远端内侧钩钢板，其特征在于：所述板体(10)远端部(3)设有三个克氏固定孔(7)。
5.根据权利要求1所述的胫骨远端内侧钩钢板，其特征在于：所述钩体(8)的宽度与板体(10)近端部(1)的宽度一致。
6.根据权利要求1—5任一项所述的胫骨远端内侧钩钢板，其特征在于：所述板体(10)和钩体(8)为钛合金制备。
CN201510034132.0A 2015-01-22 2015-01-22 一种胫骨远端内侧钩钢板 Pending CN104546104A (zh)

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104825216A (zh) * 2015-05-27 2015-08-12 熊静 一种干骺端加压固定器
CN105997221A (zh) * 2016-05-11 2016-10-12 中国人民解放军第三〇七医院 胫骨平台后缘解剖钩钢板
CN108095813A (zh) * 2017-12-22 2018-06-01 皖南医学院弋矶山医院 用于固定后交叉韧带止点撕脱骨折的内固定装置
CN109833085A (zh) * 2017-11-28 2019-06-04 上海市第六人民医院 一种双倒钩内踝解剖型钢板
CN111631844A (zh) * 2020-05-29 2020-09-08 四川大学华西医院 一种双皮质弹性固定融合器
CN111904570A (zh) * 2020-09-21 2020-11-10 山东大学齐鲁医院(青岛) 一种胫骨结节骨折用固定结构
CN114041864A (zh) * 2021-11-20 2022-02-15 南京医科大学康达学院 一种设有锁紧紧固结构的骨折内固定装置

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104825216A (zh) * 2015-05-27 2015-08-12 熊静 一种干骺端加压固定器
CN105997221A (zh) * 2016-05-11 2016-10-12 中国人民解放军第三〇七医院 胫骨平台后缘解剖钩钢板
CN109833085A (zh) * 2017-11-28 2019-06-04 上海市第六人民医院 一种双倒钩内踝解剖型钢板
CN108095813A (zh) * 2017-12-22 2018-06-01 皖南医学院弋矶山医院 用于固定后交叉韧带止点撕脱骨折的内固定装置
CN108095813B (zh) * 2017-12-22 2021-05-11 皖南医学院弋矶山医院 用于固定后交叉韧带止点撕脱骨折的内固定装置
CN111631844A (zh) * 2020-05-29 2020-09-08 四川大学华西医院 一种双皮质弹性固定融合器
CN111631844B (zh) * 2020-05-29 2022-12-23 四川大学华西医院 一种双皮质弹性固定融合器
CN111904570A (zh) * 2020-09-21 2020-11-10 山东大学齐鲁医院(青岛) 一种胫骨结节骨折用固定结构
CN111904570B (zh) * 2020-09-21 2022-03-01 山东大学齐鲁医院(青岛) 一种胫骨结节骨折用固定结构
CN114041864A (zh) * 2021-11-20 2022-02-15 南京医科大学康达学院 一种设有锁紧紧固结构的骨折内固定装置
CN114041864B (zh) * 2021-11-20 2023-01-20 南京医科大学康达学院 一种设有锁紧紧固结构的骨折内固定装置

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Application publication date: 20150429